MSN vs DNP

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At the core of advanced practice nursing is a desire to achieve three objectives: reduce costs, improve population health, and make patient experiences the best they can be. To these ends, aspiring nurse practitioners must earn at least a graduate degree to qualify for all national and local credentialing and ultimately to begin working in the profession. There are two main post-baccalaureate degrees for NPs to pursue: the master of science in nursing (MSN) and the doctor of nursing practice (DNP). The former two-year degree may be ideal for NPs eager to begin their career, and the latter four-year degree can set an NP up for a career in academia and research, and may even qualify an individual for higher pay or a management role. Also, DNPs are practice-focused (i.e., concentrated on the diagnosis and treatment of patients) compared to PhDs, which are research-focused.

Notably, the American Association of Colleges of Nursing (AACN) recommends that aspiring nurse practitioners pursue the DNP, primarily because the degree deepens the nurse’s understanding of advanced nursing issues and better prepares the nurse for the future of the profession. Some universities have been slow to adopt that recommendation as a standard, and today, there is still a wealth of MSN programs—both on-campus and online—across all NP specializations. Of course, NPs who opt for an MSN are free to complete an MSN-to-DNP program afterward, which generally takes two years.

So why would an aspiring NP choose one degree over the other? After all, NPs enjoy strong career outlooks and high salary potentials regardless of their qualifying degree. The answer is that there’s not a “right” choice here. MSN and DNP programs are inherently different, and in order to make an informed choice, it’s important for a nurse to understand how they differ, and the benefits of each.

A major differentiating factor between a MSN degree and a DNP degree is that the DNP degree is a doctoral degree. Though one does not need to have an MSN to pursue a DNP—there are both ADN- and BSN-to-DNP pathways—a DNP degree is in fact a terminal degree, meaning there is no higher nursing degree one can earn.

MSN-prepared nurse practitioners and other advanced practice nurses (e.g., nurse-midwives, nurse anesthetists, clinical nurse specialists) typically focus on patient care and case management, while DNP-prepared nurses may do that and more. DNPs tend to have a broader focus, applying evidence-based care into clinical practice and paying thought to the larger systems of care and health outcomes of populations and communities. Overall, DNPs move to improve care efficiency, safety, and effectiveness, contributing their insights to the canon of the nursing discipline to be used by the next generation of APNs and in wider applications to health policy.

Side-by-Side Comparison: MSN Degree vs. DNP Degree

To better understand the costs and benefits of pursuing one degree or the other, here is a detailed overview of what to expect from MSN and DNP programs.

Master of Science in Nursing

Doctor of Nursing Practice

Time to completion

One can apply to an MSN program with an active RN license and either an associate degree in nursing (ADN), a non-nursing bachelor’s degree, or a bachelor’s of science in nursing (BSN). Here is how long these pathways take to complete (assuming full-time study):

ADN-to-MSN: 3-5 years

BSN-to-MSN: 2 years

Please note that candidates with non-nursing bachelor’s degrees may need an additional year to complete program course prerequisites (e.g., anatomy, pharmacology, etc.) prior to beginning the MSN core program.

Similar to MSN programs, one can apply to a DNP program with a valid RN license and an ADN, a non-nursing bachelor’s, a BSN, or an MSN degree. Here is how long these pathways take to complete (assuming full-time study):

ADN-to-DNP: 5-6 years

BSN-to-DNP: 3-4 years

MSN-to-DNP: 2 years

Expected coursework

MSN courses are focused both in general, graduate-level nursing subjects and a clinical specialization. The most common specializations are adult-gerontology (primary or acute care), family health, women’s health, pediatrics (primary or acute care), psychiatric-mental health, and neonatal care. Core courses across all specializations include:

Healthcare policy and advocacy

Evidence-based nursing practice

Clinical pharmacology for advanced practice nursing

Physical assessment and diagnostic reasoning

Population health in a global society

Quality improvement and safety in healthcare systems

Advanced physiology across the lifespan

Conceptual basis of pathophysiology across the lifespan

Finally, schools such as Duke University offer the opportunity to sub-specialize as well. The available MSN concentrations are cardiology, endocrinology, HIV/AIDS, oncology, orthopedics, and veteran healthcare.

DNP programs, by contrast, hone in on leadership, health policy, and/or technology in addition to clinical work. At the post-MSN level, much of the DNP coursework will be similar across NP specializations. Columbia University, for example, has the following courses in its top-ranked DNP program:

Philosophy of bioethics

Introduction to clinical ethics

Fundamentals of comprehensive care across the lifespan I & ii (and corresponding seminars)

Scholarly writing and dissemination I & ii

Incorporating genetics and genomics in advanced practice nursing

Comparative quantitative research design and methodology

Practice leadership and quality

Health policy and advocacy

Certifications and licensure

Prior to beginning work as an NP, it’s mandatory to achieve national and state-based credentialing.

To become an NP, candidates must have a specialized certification from one of the following organizations:

To qualify, these national certifications require applicants to have an RN license; at least an MSN from a program (ACEN- or CCNE-accredited); proof of specific coursework; at least 500 supervised clinical hours; and a passing score on a comprehensive examination. These certifications last one to five years, and require continuing education (CE) credits to recertify.

Local licensing procedures and practice authority vary widely by state. Check out the main NP practice authority page for a list of state-based licensing organizations and scope-of-practice information.

In addition to achieving the national and state-based credentialing required of an MSN-prepared NP, DNPs also have the option to pursue certification from the American Board of Comprehensive Care. This relatively new credential was introduced in 2007 and also requires a passing score on an advanced examination.

To maintain this five-year certification, DNPs can retake the exam or provide proof of at least 1,000 clinical practice hours and 75 CE units.

Typical work environments

MSN-prepared NPs work in a range of clinical environments. According to the Bureau of Labor Statistics (BLS 2018), here are the percentages of NPs (including nurse anesthetists and certified nurse midwives) working in various settings:

Offices of physicians: 46 percent

Hospitals (state, local, and private): 28 percent

Outpatient care centers: 8 percent

Educational services (state, local, and private): 4 percent

Offices of other healthcare practitioners: 3 percent

Please note that these figures include both MSN- and DNP-prepared NPs.

DNP-prepared NPs may have a wider range of workplaces open to them, including all areas MSN-prepared NPs work in addition to the following:

Public health offices: This work environment enables DNPs to influence policymakers and health officials while working to create improved solutions to health issues.

Independent practice: Launching one’s own practice can allow an NP to determine work hours and what treatments one would like to offer.

Universities: A majority of NP professors hold at least a DNP or PhD in the field.

Positions and titles range greatly from executive titles to various faculty positions.

Salary

According to the Bureau of Labor Statistics (BLS May 2017), the 166,280 nurse practitioners nationally—both MSN- and DNP-prepared—made an average annual salary of $107,480 with these percentiles:

10th percentile: $74,840

25th percentile: $88,810

50th percentile (median): $103,880

75th percentile: $123,070

90th percentile: $145,630

While reliable salary data doesn’t distinguish between NPs with an MSN or a DNP, wages are typically commensurate with experience and degree achieved. Therefore, DNPs are in a better negotiating position; are prepared to take on more management responsibilities; and by extension, can expect to command higher salaries than their MSN-prepared counterparts. Overall, salary varies by region, role, place of employment, and other factors.

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